Urogynaecology & Pelvic Health

Urogynaecology is a subspecialty that focuses on the management of female pelvic floor disorders, which can significantly impact a woman’s quality of life. These disorders often include urinary incontinence, pelvic organ prolapse, and other conditions affecting the pelvic region.

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What is Urogynaecology?

Urogynaecology is a specialised field within gynaecology and urology focused on diagnosing and treating disorders of the female pelvic floor and urinary system. It addresses conditions like urinary incontinence, pelvic organ prolapse, bladder pain, and recurrent urinary tract infections, as well as complications from childbirth, menopause, and other factors that impact pelvic floor muscles and organs.

Urogynaecologists work closely with patients to provide both surgical and non-surgical treatments, which may include pelvic floor therapy, medications, and procedures like bladder or prolapse repair.

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Urinary Incontinence

Urinary Incontinence

This condition involves the involuntary leakage of urine and can be caused by factors such as childbirth, hormonal changes, or pelvic floor weakness. It is a common issue that affects a significant number of women, especially those who have given birth or are postmenopausal.

Pelvic Organ Prolapse

Pelvic Organ Prolapse

This occurs when the pelvic organs descend into or out of the vagina due to weakened pelvic floor muscles. Common types of prolapse include:

  • Cystocele Prolapse of the bladder into the anterior wall of the vagina.
  • Rectocele Prolapse of the rectum into the posterior wall of the vagina.
  • Uterine Prolapse Descent of the uterus into the vaginal canal.
Faecal Incontinence

Faecal Incontinence

This refers to the inability to control bowel movements, which can result from pelvic floor dysfunction.

Chronic Pelvic Pain

Chronic Pelvic Pain

Conditions such as interstitial cystitis or pelvic floor muscle tension can lead to chronic pain in the pelvic region.

Risk Factors

Symptoms of Pelvic Floor Disorders

  • Urinary Leakage

    Involuntary leakage of urine during activities such as coughing, sneezing, or exercising.

  • Pelvic Pressure

    A sensation of heaviness or pressure in the pelvic region.

  • Bulging or Protrusion

    The feeling of something bulging in or out of the vagina.

  • Difficulty Emptying Bladder or Bowels

    Trouble starting urination or bowel movements, or a feeling of incomplete emptying.

  • Pain

    Chronic pelvic pain, especially during intercourse or physical activity.

Treatment Options for Urogynaecological Disorders

Conservative Treatments

Conservative Treatments

  • Pelvic Floor Exercises Kegel exercises are often recommended to strengthen the pelvic floor muscles and improve bladder control.
  • Lifestyle Modifications Weight loss, dietary changes, and fluid management can help alleviate symptoms.
Medications

Medications

Depending on the condition, medications may be prescribed to manage symptoms, such as anticholinergics for overactive bladder.

Physical Therapy

Physical Therapy

A specialised pelvic floor physical therapist can provide targeted exercises and techniques to strengthen pelvic muscles and improve function.

Minimally Invasive Procedures

Minimally Invasive Procedures

  • Pessaries A pessary is a device inserted into the vagina to support pelvic organs and manage prolapse.
  • Botox Injections Used for overactive bladder, Botox can help relax the bladder muscles.
Surgical Interventions

Surgical Interventions

In cases where conservative measures are ineffective, surgical options may be considered:

  • Sling ProceduresFor urinary incontinence, surgical slings can support the urethra and prevent leakage.
  • Prolapse Repair SurgeryProcedures to repair or support pelvic organs may be necessary for severe prolapse cases.

Prevention and Long-Term Care

Engaging in regular exercise, including targeted pelvic floor exercises, is essential for strengthening the muscles that support the bladder, uterus, and bowel, helping to reduce the risk of pelvic floor disorders and enhance overall health. Maintaining a healthy weight is equally important, as excess weight adds pressure to the pelvic floor, increasing the risk of issues like incontinence or pelvic organ prolapse.

A balanced diet, along with consistent physical activity, supports both weight management and broader health benefits. Routine check-ups with a healthcare provider for pelvic health evaluations allow for early detection and treatment of potential concerns, preventing minor issues from escalating.

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